NPIMap

Jaskirat Mangat

Individual provider Active NPI General Practice Dentistry · Pine Grove, PA

NPI 1245783265 · NPPES record last updated Oct 27, 2016

Key facts

NPI
1245783265
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS040883 (PA)
Practice address
210 South Tulpehocken Street
Pine Grove, PA 17963-8935
Phone
(570) 345-8007
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS040883PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mangat Family Dentistry P.C. General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS040883 PA Yes

Addresses

Primary practice location

210 South Tulpehocken Street
Pine Grove, PA 17963-8935

Mailing address

210 S Tulpehocken St
Pine Grove, PA 17963-1014
Phone (570) 345-8007

Other providers in Pine Grove, PA

All providers in Pine Grove, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.